Etiological Evaluation and Mortality of Patients with Renal Artery Stenosis: A Single-Center Experience

Introduction: Renal artery stenosis (RAS) is a clinical picture that is evaluated as a renovascular disorder and includes many diseases in its etiology. The primary purpose of the present study was to reveal the etiology of cases followed up in the nephrology outpatient clinic due to RAS; to describe their demographic, clinical, and radiological features; and investigate their treatment and prognosis. The second aim of the study was to investigate the relationship between isolated RAS cases that cannot be attributed to any etiological cause and Takayasu's arteritis. Methods: Patients were included in retrospectively examining all patient files that were registered between January 1996 and 2018. Demographic data of the patients, date of diagnosis, initial physical examination findings, comorbid diseases, imaging findings, interventional and medical treatments, need for kidney replacement therapy, and time to hemodialysis/transplantation were recorded. Results: Out of the 17427 (8800 M/8627 F) patients, a total of 134 (70 M/64 F) patients aged over 18 years with RAS were included in the study; 60 (55%) patients had atherosclerotic RAS, whereas 23 (21.1%) patients were diagnosed with vasculitis. In total, 16 patients (13.5%) died with a mean of 6 +/- 3.4 years after admission. It was found that advanced age, low GFR at diagnosis, and small kidneys are significant and poor prognostic factors. Conclusion: A more systematic approach model can be developed in terms of applying "maximal medical treatment", which is our approach that we can currently describe as incomplete in cases of RAS with an early atherosclerotic process.